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American Journal of Surgery Aug 2022Postoperative pancreatic fistula (POPF) is a feared complication in pancreatic resection. Gravity drainage (GD) is hypothesized to reduce POPF versus closed-suction...
BACKGROUND
Postoperative pancreatic fistula (POPF) is a feared complication in pancreatic resection. Gravity drainage (GD) is hypothesized to reduce POPF versus closed-suction drainage (CSD). We sought to evaluate this theory.
METHODS
Six-hundred-twenty-nine patients undergoing pancreatic resection between 2013 and 2020 were analyzed with multivariable logistic regression for the outcomes of POPF and clinically-relevant POPF (crPOPF).
RESULTS
Three-hundred-ninety-seven patients (63.1%) underwent pancreaticoduodenectomy and 232 (36.9%) underwent distal pancreatectomy. Suction drains were placed in 588 patients (93.5%) whereas 41 (6.5%) had GDs. One-hundred-twenty-five (27.6%) experienced a POPF; 49 (10%) crPOPFs. On multivariable analysis, suction drainage was not associated with increased risk of POPF (OR 0.76, 95% CI 0.30-1.93, P = 0.57) or crPOPF (OR 0.99, 95% CI 0.30-3.26, P = 0.98).
CONCLUSION
Suction drainage does not promote POPF when compared to GDs. Drain type should be determined by surgeon preference, while taking into account nursing and patient-specific considerations especially when patients are discharged with drains.
Topics: Drainage; Humans; Pancreatectomy; Pancreatic Fistula; Pancreaticoduodenectomy; Postoperative Complications; Risk Factors; Suction
PubMed: 35248372
DOI: 10.1016/j.amjsurg.2022.02.063 -
The Journal of Trauma and Acute Care... Aug 2014The study aimed to establish the benefits of using chest tubes with negative pleural suction against trapped water in patients with penetrating or blunt chest trauma who... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The study aimed to establish the benefits of using chest tubes with negative pleural suction against trapped water in patients with penetrating or blunt chest trauma who underwent tube thoracostomy, in terms of the incidence of complications, such as persistent air leak, clotted hemothorax, empyema, and duration of stay.
METHODS
Patients who underwent tube thoracostomy because of traumatic pneumothorax, hemothorax, or hemopneumothorax were randomly assigned into one of two groups: in Group 1, the three-bottle drainage system was connected to a negative suction; in Group 2, no suction was given. Patients who required mechanical ventilation or emergency surgery (thoracotomy or thoracoscopy) either at the time of admission to the institution or immediately after the tube thoracostomy, patients who had histories of thoracic procedures or chronic pulmonary diseases (chronic obstructive pulmonary disease, diffuse interstitial lung disease), and patients with multiple injuries with severe traumatic brain injury and a Glasgow Coma Scale (GCS) score less than 8 of 15 were excluded from the study. Hospital stay, duration of tube thoracostomy, prolonged fistula, and other clinical variables were compared.
RESULTS
One hundred ten patients were included, 56 in the group with suction and 54 in the group without suction. There were no differences in the demographic characteristics of each group. There were no differences between the groups in terms of hospital stay (p = 0.22), duration of tube thoracostomy (p = 0.35) (3 days in each group), or complications. However, the probability of air leak presence in time was greater for the Group 1 patients with negative suction versus the Group 2 patients (p = 0.023).
CONCLUSION
The use of negative pleural suction did not demonstrate advantages over the three-bottle chest drainage system without suction in patients with uncomplicated traumatic pneumothorax, hemothorax, or hemopneumothorax.
LEVEL OF EVIDENCE
Therapeutic study, level II.
Topics: Adult; Chest Tubes; Female; Hemopneumothorax; Hemothorax; Humans; Length of Stay; Male; Pneumothorax; Suction; Thoracic Injuries; Thoracoscopy; Thoracotomy; Treatment Outcome; Wounds, Nonpenetrating; Wounds, Penetrating
PubMed: 25058250
DOI: 10.1097/TA.0000000000000281 -
Annals of Surgery Jun 1990During a 42-month period, 65 patients sustaining pancreatic injuries were treated. They were randomized on alternate days (two separate trauma teams) to receive sump (S)... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
During a 42-month period, 65 patients sustaining pancreatic injuries were treated. They were randomized on alternate days (two separate trauma teams) to receive sump (S) or closed suction (CS) drainage. Twenty-eight patients were randomized to S and 37 to CS; there were six early deaths, which precluded drainage analysis, leaving 24 evaluable S patients and 35 CS patients. Penetrating wounds occurred in 71% and blunt in 29%. No significant differences appeared between the groups with respect to age, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), or grade of pancreatic injury. Twelve patients in each group required resection and drainage for grade III injuries, with the remaining patients receiving external drainage alone. Five of twenty-four S patients versus one of thirty-five CS patients developed intra-abdominal abscesses (p less than 0.04). We conclude that septic complications after pancreatic injury are significantly reduced by CS drainage. Bacterial contamination via sump catheters is a major source for intra-abdominal infections after pancreatic trauma.
Topics: Abscess; Adult; Drainage; Female; Humans; Male; Pancreas; Prospective Studies; Randomized Controlled Trials as Topic; Suction; Trauma Severity Indices; Wound Infection
PubMed: 2192695
DOI: 10.1097/00000658-199006000-00011 -
Journal of the American Animal Hospital... 1996The principal and dynamics of closed-suction wound drainage lend themselves to use on auricular hematomas. This type of drainage was evaluated in the treatment of 10...
The principal and dynamics of closed-suction wound drainage lend themselves to use on auricular hematomas. This type of drainage was evaluated in the treatment of 10 auricular hematomas on nine animals. Seven animal owners rated the results of the procedure as "good," and two rated them as "fair." The two rating the procedure as having "fair" results owned dogs with allergic dermatitis, and the auricular hematomas recurred. In both dogs, auricular hematomas again recurred after other means of treatment were used. If the pocket for the vacuum tube is not secure and the animal is quite active, or if it molests the bandage, or both, it is possible for the tube to break or the needle to come off of the tubing.
Topics: Animals; Dog Diseases; Dogs; Ear Diseases; Female; Hematoma; Male; Suction
PubMed: 8963734
DOI: 10.5326/15473317-32-1-36 -
Archives of Orthopaedic and Trauma... Dec 2009Closed suction drainage in joint replacement surgery has been considered to carry an obvious risk of bacteria invasion. Previous studies have shown controversial results... (Comparative Study)
Comparative Study Review
Prognostic value of suction drain tip culture in determining joint infection in primary and non-infected revision total hip arthroplasty: a prospective comparative study and review of the literature.
INTRODUCTION
Closed suction drainage in joint replacement surgery has been considered to carry an obvious risk of bacteria invasion. Previous studies have shown controversial results regarding the role of suction drain culture in predicting artificial joint infection. Furthermore, the efficacy of the method has not been established in revision total hip or knee arthroplasty.
MATERIALS AND METHODS
Suction drain tips from 110 patients who underwent 73 primary and 37 revision non-infected total hip arthroplasties were prospectively cultured. The drains removed at 48 h postoperatively. The patients had an average age of 64.3 years (range 25-81 years) and followed up for 2-4 years (average 2.8 years).
RESULTS
Positive cultures were identified in two primary (2.74%) and six revision (16.22%) total hip replacements (p = 0.017). The most frequently isolated microorganisms were Staphylococcus aureus (3 cases) and S. epidermidis (2 cases). Resistance to perioperative antibiotics was found in three out of eight isolated pathogens. However, no infection was recorded in any of the eight patients whose cultures found positive.
CONCLUSION
Although suction drains are more often contaminated in revision total hip arthroplasty, the prognostic value of the method in determining joint infection is very limited and its routine use is not supported from the clinical data.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Bacteria; Bacterial Infections; Female; Humans; Male; Middle Aged; Postoperative Care; Prognosis; Prosthesis Failure; Prosthesis-Related Infections; Reoperation; Suction
PubMed: 19255766
DOI: 10.1007/s00402-009-0844-6 -
Pediatric Surgery International Mar 2002Controversy persists regarding the treatment of pilonidal sinus (PS). To evaluate the efficacy of excision with primary closure and closed-suction drainage in adolescent...
Controversy persists regarding the treatment of pilonidal sinus (PS). To evaluate the efficacy of excision with primary closure and closed-suction drainage in adolescent patients, between 1990 and 1999, 34 consecutive patients aged 13-18 years (mean 16.4) underwent PS excision with primary closure and suction drainage. Anesthesia was general in 16 (47%) and spinal in 18 (53%) with a statistical age difference ( P< 0.001) (15.5 vs 17.2 years, respectively). No complications due to the anesthetic were observed. Twenty-one patients (61.8%) had day-case surgery while the others were hospitalized for 2 to 4 days (average 2.3 days). The drain was removed on postoperative day 2 to 6 (average 2.2). Primary healing with no postoperative complications occurred in 30 patients (88.2%); 1 underwent partial opening of the wound because of rupture of the drainage tube during its removal. Postoperative infections requiring incision, drainage, and lay-open occurred in 3 cases (9.1%). No recurrence was found at 12-month follow-up. One recurrence (2.9%) was noted 3 years after surgery. Excision with primary closure and closed-suction drainage as an ambulatory procedure is thus a simple and effective method of treatment of uncomplicated PS in adolescents.
Topics: Adolescent; Ambulatory Surgical Procedures; Anesthesia, General; Anesthesia, Spinal; Female; Humans; Male; Pilonidal Sinus; Recurrence; Suction; Treatment Outcome
PubMed: 11956785
DOI: 10.1007/s003830100683 -
Archives of Otolaryngology (Chicago,... Nov 1982This study was undertaken to determine what optimal levels of suction pressure were necessary to provide good drainage volume and obliteration of any dead space and also...
This study was undertaken to determine what optimal levels of suction pressure were necessary to provide good drainage volume and obliteration of any dead space and also to determine the prevalence of clotting and complications secondary to various levels of suction pressure. The patients were grouped by their degree of nutritional depletion, prior radiation exposure, the types of surgical procedures undergone, and the results of tests using four levels of suction pressure. Three of the suction pressure values were obtained with a wall suction and one was obtained using a portable closed system. All wall suction pressure levels were certainly comparable with the portable unit. However, the portable unit provided continuous suction pressure when the patients were ambulatory and was not associated with any statistically significant increase in wound complications or equipment failure.
Topics: Head and Neck Neoplasms; Humans; Postoperative Complications; Suction; Wound Healing
PubMed: 7138366
DOI: 10.1001/archotol.1982.00790590045013 -
Hernia : the Journal of Hernias and... Jun 2018
Comment to: Preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomised controlled trial. Fan JKM, Liu J, Chen K, Yang X, Xu X, Choi HK, Chan FSY, Chiu KWH, Lo CM.
Topics: Double-Blind Method; Hernia, Inguinal; Herniorrhaphy; Humans; Prospective Studies; Seroma; Suction
PubMed: 29681017
DOI: 10.1007/s10029-018-1762-8 -
The Journal of Arthroplasty Feb 2010The aims of this study were to determine (1) whether the duration of closed suction drainage affects the occurrence and duration of prolonged serous drainage and (2) if... (Comparative Study)
Comparative Study Randomized Controlled Trial
The aims of this study were to determine (1) whether the duration of closed suction drainage affects the occurrence and duration of prolonged serous drainage and (2) if closed suction drains could be omitted according to the wound and/or thigh appearance after unilateral primary total hip arthroplasty. One hundred thirty-nine patients undergoing total hip arthroplasty were randomized into 3 groups: 42 patients received no drainage, 46 patients received drainage for 24 hours, and 51 patients received drainage for 48 hours. No differences with respect to occurrence and duration of prolonged serous drainage were found between the 2 groups with drains. Although no prolonged serous drainage occurred, the swelling of the thigh was significantly greater (P < .001) and the occurrence of prolonged thigh pain was significantly higher (P = .01) in the group without drainage.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Female; Hip Joint; Humans; Incidence; Male; Middle Aged; Osteoarthritis, Hip; Pain; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus; Suction; Surgical Wound Infection; Thigh; Time Factors
PubMed: 19056215
DOI: 10.1016/j.arth.2008.08.014 -
British Journal of Neurosurgery Oct 2023Closed wound suction drains are commonly used in spinal surgery. Severe neurological complications related to their use are rare. Here, we report a case of a dural...
Closed wound suction drains are commonly used in spinal surgery. Severe neurological complications related to their use are rare. Here, we report a case of a dural rupture and subsequent spinal cord herniation related to the use of closed suction drains after posterior decompression and fixation surgery for spinal metastasis.
Topics: Humans; Drainage; Neurosurgical Procedures; Spinal Cord; Suction; Female; Middle Aged
PubMed: 33576692
DOI: 10.1080/02688697.2021.1885623